Can Cervical Screening Prevent Cancer?

[sound of television in background] I'm Richard Smith. I'm a consultant Gynaecological Surgeon at the West London Gynaecological Cancer Centre which is part of Imperial College. Cervical screening is where women go to their doctor to have a smear done and the purpose of taking smears is to detect CIN 2 and 3 and if you treat those conditions, then you virtually one hundred percent of the time will prevent people getting cancer. 90 percent of people who have a smear will find that it is a normal smear and in a woman's life time, ten percent of all women will get an abnormal smear. How many of those will get a high grade legion? Meaning CIN 2 or 3, then you are down to one to two percent. How many people will actually have cervical cancer, detected from a smear? Way less than one percent. So although most women going for that smear believe that it's been done to detect cancer, it is not, and it very, very rarely ever does detect cancer. Usually we don't treat CIN 1 at first diagnosis. It has to be there for at least six months. And if you've got borderline then you're unlikely to get any treatment at all. The success of the treatment - very very high. 95 to 98 percent, at first treatment. And if it fails, so if you're unlucky to be in the two to five percent, then the second treatment, because you do the same treatment again, has got the same efficacy the second time round. The chance of you getting through that net and getting cervical cancer is incredibly low. The important thing to say is for cervical pre-cancer, there are no symptoms. so there is no discharge, no bleeding, no pain, nothing. Now, for cervical cancer that's different and the signs there, are people can get pain but more often their sign is that they're getting bleeding between their periods or more pertinently bleeding after intercourse. Of course it's really important to say that the vast majority of people who have those symptoms do not have cervical cancer, but those are symptoms of cervical cancer. [Richard instructing a woman where to go] You may well come across the term HPV and HPV stands for 'human papillomavirus'. Now that gets colloquially referred to as wart virus, which is a bad term because the types of human papillomavirus which cause cervical pre-cancer, and can lead on to cervical cancer, do not cause warts. Up to 85 percent of all men and women will get infected with human papillomavirus at some point in their lives, but the vast majority of people will get rid of the papillomavirus without ever getting an abnormal smear. 90 percent of them will get rid of it without having any cervical pre-cancer or cervical cancer. The other thing which is very contentious about human papillomavirus is a lot of people think that it's a sexually transmitted infection and therefore somehow implies infidelity on either their part, or their partner's part, and that is not true. So the HPV vaccine has been developed because we know that HPV is found within cervical tumours. And this vaccine has been well tried, well tested and is at the moment, in the United Kingdom, being given to girls who are 12 to 15 years of age, and there is a catch-up program to age 18. It's highly effective against two types of HPV, 16 and 18 and they account for 70 percent of all the cases of cervical cancer. Now of course that leaves 30 percent that are not covered by the vaccine, which is why even if you've had the vaccine, you must still go to have smears. The success of the smear programme is so obvious to somebody in my position because we're actually doing very few operations these days for cervical cancer and that is a testimony to the success of this programme and the fact that the vast majority of the population go for smears and go for those smears regularly, it's really important and is making the big difference in reducing the rate of *** cancer. [Announcer] For information, help, or if you just want to chat, call the Macmillan support line on 0808 808 00 00 or visit macmillan.org.co.uk